My 83-year-old father is a hoarder and a narcissist; he will talk without pause about people or subjects that are only of interest to him, so that his listeners are trapped. He creates a maelstrom of chaos around him. A day spent with him almost always ends with me feeling desperate and crazed. He is emotionally manipulative and knows exactly how to pour on the guilt.

I live in the UK, overseas from my family. My father recently had a serious operation and was convinced he was going to die. Just before the procedure, he asked if he could come and visit me after as “it would give me something to live for” (he has plenty of other things to live for). As it was such a heightened emotional time, I said he could.

I live on my own in a very small flat and have not invited him to stay before, not only because of the size constraints of my home but also because I find being with him 24/7 for any length of time takes me to the edge of my sanity – in fact, it takes me months to recover.

I am not alone in feeling like this: my brother and his family are driven completely crazy by him and likewise need a long recovery period after he has been to stay. Just the thought of a week with him taking over my small home makes me so upset that I can’t sleep, and he lives far enough away that less than a week isn’t really reasonable. Staying in a hotel isn’t a possibility.

This all makes me sound so heartless and I’m close to tears as I write this. I love my father and wish him only well, but it’s a bit like being mentally tortured: there are no physical bruises and breaks that I can show anyone but, inside, my father has badly damaged me. Having said that, I have made a good life for myself. I am mostly happy, have friends, a good job and so on.

Is it OK to put my needs first and say that I don’t know when it will be convenient, but when it is I will let him know? Or, because he’s an old man and so keen to come, will I be left feeling guilty for not letting him do what he likes?

The truth is, if he could come for an afternoon or an evening, that would be reasonable, but to stay here is just too much for me.

Saying no is almost the easy part – it’s the guilt that is hard to deal with.

Miranda Passey, a child and adult psychotherapist (childpsychotherapy.org.uk), thinks that what you are doing – something we all do to a degree – is bringing your child self into your exchanges with him. “Contact with your father makes you feel like a helpless child in relation to him. As an adult, you are in a position to say, ‘I don’t want you to come.’”

Something about talking to your father takes you back to being a child and feeling that you can’t say no, at least without feeling immensely guilty.

I had a long discussion with Passey about this. I’ve said in past columns that guilt can stop an adult from parenting confidently, but it can also stop an adult child from asserting their needs with a parent.

“Guilt – ordinary guilt – is an important part of life,” says Passey. “It gives you a conscience and it can bring an impetus to try and repair things. But when there is too much of it, guilt disables and can make you impotent.”

Passey said that this “excessive” guilt is often learned when one is really young and vulnerable – it becomes a familiar groove we can then get into when interacting with certain people. We all have family patterns we fall into, and it’s really hard to come out of them.

You didn’t mention your mother – is she around to counteract your father’s behaviour?

Somewhere along the line, you have learned that you can’t say no to your father, that you are in some way responsible for him and his emotional wellbeing. You aren’t.

But, and here’s the clincher for you, Passey thinks that fear of facing your own anger at him is stopping you from saying no. You also need to take responsibility for your negative feelings (just as your father needs to) and realise that it’s OK to have them.

Passey thinks that it’s quite important for you to learn that you can love your dad but also really dislike – hate – some of the things he does at the same time. And that’s OK. Let me repeat that. You can love your father but hate some of the things he does and protect yourself – that’s OK.

From a practical point of view, could you visit him so you can limit your interaction with him?

If not, then yes, of course it is all right for you to say no to your father. But, like I said, that’s the easy part. Don’t let guilt force you to sacrifice yourself at the altar of dysfunctional parent-child relationships.

This feature originally appeared in The Guardian Family section on 16th April 2016.